Lives and Costs Saved by Expanding and Expediting Coronavirus Disease 2019 Vaccination

Abstract

Background: With multiple coronavirus disease 2019 (COVID-19) vaccines available, understanding the epidemiologic, clinical, and economic value of increasing coverage levels and expediting vaccination is important.

Methods: We developed a computational model (transmission and age-stratified clinical and economics outcome model) representing the United States population, COVID-19 coronavirus spread (February 2020-December 2022), and vaccination to determine the impact of increasing coverage and expediting time to achieve coverage.

Results: When achieving a given vaccination coverage in 270 days (70% vaccine efficacy), every 1% increase in coverage can avert an average of 876 800 (217 000-2 398 000) cases, varying with the number of people already vaccinated. For example, each 1% increase between 40% and 50% coverage can prevent 1.5 million cases, 56 240 hospitalizations, and 6660 deaths; gain 77 590 quality-adjusted life-years (QALYs); and save $602.8 million in direct medical costs and $1.3 billion in productivity losses. Expediting to 180 days could save an additional 5.8 million cases, 215 790 hospitalizations, 26 370 deaths, 206 520 QALYs, $3.5 billion in direct medical costs, and $4.3 billion in productivity losses.

Conclusions: Our study quantifies the potential value of decreasing vaccine hesitancy and increasing vaccination coverage and how this value may decrease with the time it takes to achieve coverage, emphasizing the need to reach high coverage levels as soon as possible, especially before the fall/winter.

Keywords: COVID-19; coronavirus; coverage; rate; vaccination.

Figure 1.

Impact of increasing vaccination coverage for coronavirus disease 2019 vaccines when 20% of the population has already been infected by vaccination onset (on 4 January 2021) with a 70% vaccine efficacy when varying the days needed to achieve different coverage levels on the number of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases (A), the number of deaths (B), direct medical costs (C), and productivity losses due to absenteeism (D). Assumes an $85 vaccination cost. Cases and deaths are simulated through 31 December 2022; scenarios assume reproduction number values such that cases decrease in February and continue downward in March, then start to increase in September, and the following year nonpharmaceutical interventions are discontinued.

Figure 2.

Impact of increasing vaccination coverage for coronavirus disease 2019 vaccines when 30% of the population has already been infected by vaccination onset (on 4 January 2021) with a 70% vaccine efficacy when varying the days needed to achieve different coverage levels on the number of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases (A), the number of deaths (B), direct medical costs (C), and productivity losses due to absenteeism (D). Assumes an $85 vaccination cost. Cases and deaths are simulated through 31 December 2022; scenarios assume reproduction number values such that cases decrease in February and continue downward in March, then start to increase in September, and the following year nonpharmaceutical interventions are discontinued.

Figure 3.

Impact of increasing vaccination coverage for coronavirus disease 2019 vaccines per person vaccinated with a 70% vaccine efficacy when varying days needed to achieve different coverage levels on the number of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases (A) and direct medical costs (B) when different proportions of the population have already been infected by vaccination onset (on 4 January 2021). Assumes an $85 vaccination cost. Cases and costs are simulated through 31 December 2022; scenarios assume reproduction number values such that cases decrease in February and continue downward in March, then start to increase in September, and the following year nonpharmaceutical interventions are discontinued.

Figure 4.

Impact of increasing vaccination coverage for coronavirus disease 2019 vaccines when varying days needed to achieve different coverage levels on the total number of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases when vaccination onset starts once 30% of the population has already been infected with a 50%, 70%, and 90% efficacious vaccine (A), and on the number of SARS-CoV-2 cases per person vaccinated with a 50%, 70%, and 90% efficacious vaccine (B). Cases are modeled through 31 December 2022; scenarios assume reproduction number values such that cases decrease in February and continue downward in March, then start to increase in September, and the following year nonpharmaceutical interventions are discontinued.